CPT 22207 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 22 - Increased Procedural Services |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22207 |
National average reimbursement for CPT 22207 by major payers:
$3,141.67
$3,209.74
$3,424.53
$3,955.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 22207 | ||||||
United | 22207 | $7888.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $6047.00 | 1861052896 - PREMIER ADULT AND CHILDRENS SURGERY CENTER LLC | 651005912 - (FL) SUMMERLIN BEND SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $850.00 | 1538157037 - WEST CENTRAL SURGICAL CENTER, LLC | 200088459 - (OH) WEST CENTRAL SURGICAL CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $1621.00 | 1720080823 - BAPTIST-EMSC LP, EAST MEMPHIS SURGERY CENTER | 621846584 - (TN) BAPTISTEMSC LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $3870.00 | 1912627712 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | 883537315 - CENTER FOR ROBOTIC SURGERY OF LOUISIANA LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $1698.00 | 1427116367 - BROOK PLAZA AMBULATORY SURGICAL CENTER, INC. | 112877356 - (NY) BROOK PLAZA AMBULATORY SURGICAL CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $4072.00 | 1568963189 - BAPTIST SURGERY AND ENDOSCOPY CENTERS, LLC, BAPTIST HEALTH ENDOSCOPY CENTER AT MIAMI BEACH | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $6365.00 | 1881013142 - ADVANCED SURGERY CENTER OF TAMPA, LLC | 463891843 - (FL) ADVANCED SURGERY CENTER OF TAMPA, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $2000.00 | 1144380593 - SURGERY CENTER OF ALLENTOWN LLC, SURGERY CENTER OF ALLENTOWN | 204532105 - (PA) SURGERY CENTER OF ALLENTOWN | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $5963.00 | 1013539709 - BSC BILTMORE LLC | 850820003 - (AZ) BSC BILTMORE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $4140.00 | 1770588584 - PHYSICIANS SURGERY CENTER LLC, NATIONAL SPINE & ORTHO SURGERY CENTER OF FT. MYERS | 592924183 - (FL) PHYSICIANS SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $4075.00 | 1467101907 - PEACE RIVER SURGERY CENTER | 853047089 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $1710.00 | 1497801237 - WOOSTER CLINIC, LLC | 341855775 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $3800.00 | 1093389421 - PEACHTREE ORTHOPAEDIC SURGERY CENTER-NORTH, LLC | 862640910 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTERNORTH LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22207 | $1827.00 | 1871557652 - PORT ST LUCIE SURGERY CENTER LTD | 621600419 - (FL) PORT ST LUCIE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 22207 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22207 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 22207 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 22206-CPT | High | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Thoracic |
| 22207-CPT | High | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Lumbar |
| 22208-CPT | Moderate | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Each Additional Verebral Segment (List Separately In Addition To Code For Primary Procedure) |
| 22212-CPT | High | Spine Osteotomy,Posterior,Corr.Deform,1 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22207 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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